CMS Price Transparency Data

Tdap vaccine (tetanus, diphtheria, pertussis)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 90715 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90715
Insurance Median: $253
Cash Discount Price: $455
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Tdap vaccine (tetanus, diphtheria, pertussis) at Eastern Idaho Regional Medical Center is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $455. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$455

Average discount available for prompt cash payment at this facility.

Insurance Median

$253

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$33 - $432	N/A
Molina	$33	N/A
Regence Blue Shield	$50	N/A
Cigna	$60	N/A
United	$65 - $263	N/A
Select Health	$138	N/A
Select Health Ichn Brightpath	$138 - $154	N/A
Select Health Idaho (Eirmc Only)	$145	N/A
Aetna	$179 - $221	N/A
Doug Andrus Distributing	$182	N/A
University of Utah	$191	N/A
Pacificsource Health	$191 - $244	N/A
Mountain Health Co-Op	$227 - $341	N/A
First Choice Health of Washington	$273	N/A
Moda	$283	N/A
Dmba	$293	N/A
Prime Health	$341 - $386	N/A
Triwest Healthcare Alliance	$364	N/A
Geha PPO USA	$364	N/A
Multiplan	$382 - $409	N/A
Humana	$382	N/A
First Choice of the Midwest	$409	N/A
St. John's Health Network	$409	N/A
Interwest Health	$409	N/A
Coventry First Health	$414	N/A
Shashone-Bannock Tribal Health	$455	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $455.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90715.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Eastern Idaho Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90715.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.